When managing kidney cancer, clinicians have traditionally used a one-size-fits-all approach. However, emerging evidence is demonstrating that all kidney cancer patients are not the same. Likewise, not all localized and metastatic kidney cancers are the same. Improving survival rates in kidney cancer is paramount, and several new targeted therapies that have been introduced to the treatment armamentarium have been shown to improve survival. As these therapies continue to emerge as viable treatment options, it’s important to determine the patients who stand to benefit most from them. New Long-Term Data In the November 1, 2008 issue of Cancer, my colleagues and I had a study published in which we assessed nearly 1,500 patients treated for kidney cancer in the last 15 years. Our investigation used an integrated staging system—developed at UCLA—which brought together medical oncologists, urologists, surgeons, clinical trial experts, and scientists for collaboration. A key finding of our study was that patients with localized kidney cancer could have low-, intermediate-, or high-risk cancers, and some may have better outcomes than others depending on the aggressiveness of the disease. Patients with low-risk, localized cancer had a 5-year survival rate of 97% and a 10-year survival rate of 92%. Those at intermediate-risk had 5- and 10-year survival rates of 81% and 61%, respectively. High-risk patients had 5- and 10-year survival rates of 62% and 41%, respectively. In the past, these groups of patients may have been treated in similar manners, but it’s clear that they should be treated individually according to their risk levels. In patients with metastatic kidney cancer, our study showed that those with low-risk disease should receive aggressive...